Excess mortality after hospitalisation for vertebral fracture
- 481 Downloads
An excess mortality is well described after vertebral fracture. Deaths are in part related to co-morbidity, but could also be due to the fracture event itself, either directly or indirectly. The aim of this study was to examine the quantum and pattern of mortality following vertebral fracture. We identified 16,051 men and women aged 50 years or more with a vertebral fracture that required hospitalization in 28.8 million person years from the patient register of Sweden. Mortality after vertebral fracture was examined using Poisson models applied to fracture patients and compared to that of the general population. At all ages, the risk of death was markedly increased immediately after the event. After a short period of declining risk, the risk increased with age at a rate that was higher than that of the general population and comparable to that 1 year after hip fracture. The latter function was assumed to be due to deaths related to co-morbidity and the residuum assumed to be due to the vertebral fracture. Causally related deaths comprised 28% of all deaths associated with vertebral fracture (depending on age). We conclude that a minority of deaths following hospitalization for vertebral fracture are attributable to the fracture itself under the assumptions we used.
KeywordsMortality Vertebral fracture
We are grateful to the National Board of Health and Social Welfare, EPC, Sweden for access to the patient records of Sweden. We acknowledge the unrestricted support of the International Osteoporosis Foundation, the International Society for Clinical Densitometry, the Alliance for Better Bone Health, G-E Lunar, Lilly, Hologic, Pfizer, Roche, Novartis and Wyeth.
- 10.Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153Google Scholar
- 13.Ismail AA, O’Neill TW, Cooper C, Finn JD, Bhalla AK, Cannata JB, Delmas P, Falch JA, Felsch B, Hoszowski K, Johnell O, Diaz-Lopez JB, Lopez Vaz A, Marchand F, Raspe H, Reid DM, Todd C, Weber K, Woolf A, Reeve J, Silman AJ on behalf of the EPOS study group (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis study (EPOS). Osteoporos Int 8:291–297CrossRefPubMedGoogle Scholar
- 17.Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone (in press)Google Scholar
- 20.Nevitt MC, Thompson DE, Black DM, Rubin SR, Ensrud K, Yates AJ, Cummings SR, for the fracture intervention trial research group (2000) Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Arch Int Med 160:77–85CrossRefGoogle Scholar